Recurrent pneumonia post atrial fibrillation ablation: do not forget to look for pulmonary vein stenosis

Article Article scientifique Rapport de cas Recurrent pneumonia post atrial fibrillation ablation: do not forget to look for pulmonary vein stenosis eng 2022-12-07 2022-12-07 author Mizuno Aki 0000-0001-9534-1390 Department of Cardiology, Geneva University Hospital, Geneva, Switzerland aki.mizuno9@gmail.com stephane.noble@hcuge.ch. 659950 author Mauler-Wittwer Sarah Department of Cardiology, Geneva University Hospital, Geneva, Switzerland. 405911 author Mueller Hajo 0000-0001-9366-9499 Department of Cardiology, Geneva University Hospital, Geneva, Switzerland. 89204 Département de médecine (DEMED) author Noble Stéphane Laurent 0000-0002-8018-2857 Department of Cardiology, Geneva University Hospital, Geneva, Switzerland aki.mizuno9@gmail.com stephane.noble@hcuge.ch. 87673 Département de médecine (DEMED) e250896 10.1136/bcr-2022-250896 36593603 1757-790X PMC9730375 https://casereports.bmj.com/content/15/12/e250896 A man in his 50s presented with persistent chest pain, haemoptysis, cough and dyspnoea 5 months after undergoing catheter ablation for atrial fibrillation (AF). Several chest CT scans suggested pneumonia. Despite adequate treatment for recurrent pneumonia, symptoms persisted. While reviewing the initial chest CT, a partial venous infarction of the left lower lobe associated with severe left inferior pulmonary vein stenosis (PVS) was diagnosed. Stenting of the left inferior pulmonary vein with a vascular bare metal stent was performed, guided by fluoroscopy and transoesophageal echocardiography. Dual antiplatelet therapy (aspirin/clopidogrel) was introduced for 3 months, followed by long-term aspirin monotherapy. The treatment resulted in relief of his symptoms and the resolution of pulmonary opacities on chest CT. Despite low frequency, AF ablation remains the most common cause of acquired PVS. As highlighted in this case, symptoms are not specific and include recurrent pulmonary infection with delayed management. Arrhythmias Interventional cardiology Pacing and electrophysiology Pneumonia (infectious disease) Radiology (diagnostics) Male Humans Stenosis, Pulmonary Vein / diagnostic imaging Stenosis, Pulmonary Vein / etiology Stenosis, Pulmonary Vein / surgery Atrial Fibrillation Pulmonary Veins / diagnostic imaging Pulmonary Veins / surgery Constriction, Pathologic / surgery Catheter Ablation / adverse effects Pneumonia / complications Treatment Outcome Dewey 616 56 Département de médecine 221 false BMJ case reports 15 12 3a42f341-91b5-40b8-97d4-7d099c221cde Article (Published version) Public Article_scientifique_from_unpaywall.pdf 1099743 application/pdf CC BY-NC-4.0 a3e995884cae6bfc052c02fc18df0b117ba503068538b3e36f10eccf92bad4d8 openAccess Faculté de médecine / Section de médecine clinique / Département de médecine

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Recurrent pneumonia post atrial fibrillation ablation: do not forget to look for pulmonary vein stenosis	BMJ case reports			2022	26	280

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